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MediumNeurologyCluster headacheau-amcau-acem

A 31-year-old man presents with recurrent unilateral periorbital headaches lasting 45 minutes, occurring twice daily for the last 2 weeks. The pain is excruciating, associated with ipsilateral lacrimation and nasal congestion. He is agitated and paces during attacks. Neurological examination is normal. What is the most appropriate acute treatment?

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